To document utilization of radiological examinations in pregnant women over ten years in one academic medical center from 1997-2006.

At our academic institution, every pregnant woman exposed to radiation during an imaging exam is recorded in a database compiled by medical physics. The examinations were comprised of radiographic plain film (PF), nuclear medicine (NM), and computed tomography (CT) examinations. We performed a retrospective review of the database to document the utilization of these radiological examinations in this patient population. We documented the number of patients, number of each type of examination, date of the exam, and the estimated radiological dose to the fetus during each year studied from 1997-2006 and compared this to the number of deliveries per year.

A total of 5235 exams were performed on 3249 patients during the 10 years of the study. The number of patients and examinations increased every year from 231 patients undergoing 325 examinations in 1997 to 447 patients undergoing 730 examinations in 2006, an 89% increase in patient number and 121% increase in examinations. During the same ten years, the total number of deliveries changed from 8661 to 9261, an increase of only 7%. While the number of PF increased an average of 7% per year, and the number of NM examinations increased an average of 12% per year, CT examinations increased an average of 25% per year. During this time period, the number of deliveries stayed nearly static with an average increase of only 1% per year. The average estimated fetal radiation exposure for CT was 0.69 rads (range 0.001 -66.6), PF 0.0015 rads (range 0.001 to 2.25), and for NM was 0.040 rads (range 0.001 to 0.77).

Overall utilization of radiological examinations in pregnant women increased by 121% over ten years with an increase in the patient population of only 7%. The greatest increases were in utilization of CT which also averaged the greatest overall radiation exposure to the fetus.

Documenting increased utilization in pregnant women is important to raise awareness of the potential of any adverse effects of increased imaging and to curb inappropriate usage in the future.